Book review Where India Goes

Why is sanitation policy in rural India not better designed around its challenges, despite the lessons of evidence and experience? Why there is no well-funded or well-staffed effort to promote latrine use and behaviour change? Why there is no credible public survey tracking open defecation – rather than tracking latrine construction – and monitoring and managing progress towards 2019 goal? Why do the documents and employees of neither the Indian state nor the international development agencies emphasize the central challenges of caste? Are these possible activities absent because of high costs or low benefits? Are they too difficult, or too undesirable, and in either case to whom?

Why I picked this book?

I have noticed and wondered why over the years and still India fares so badly on Human Development Index. Be it infant mortality, stunted child growth, cleanliness, open defecation and many other such parameters we fair very badly. The general perception is poverty and inequality are the main reasons for all this. But then, we fair badly on the above parameters as compared to the countries which are poorer than us, so what could be the reason. This book was about open defecation and its consequences, so wanted to know more about why after so many years why the people in Indian villages (northern India primarily) still defecates in open and how does it impact the health and overall wellness of the people.

The Book

Author Diane Coffey and Dean Spears have done some in-depth research on the problem of open defecation in rural India, primarily the north Indian villages. They came up with some interesting facts, during their research, which are eye opening and completely far off from the perception of people, especially the urban people, about the reasons for open defecation. With their findings the authors tried to understand the impact of open defection on the health of the children, the economic impact of it. Also, the various sanitation programs launched since the 1990s and how effective they were/are in resolving the problem of open defecation.

The most common argument that we have for open defecation that people in rural village are poor, uneducated and they don’t have access to toilets and if they have access to toilets, they don’t have access to water, and these are the reasons people in villages defecate in open. The authors in their survey found that all these are nothing, but fallacies and the core issues are something different, which either the policymakers are not aware of or if they are aware, they don’t want to address it. The sole focus of the sanitation and open defecation free India programs have been to construct the toilets with the assumption that people don’t have access to toilets and that is why they defecate in open.

However, with the data they have collated it come out that access, education, poverty are not the reasons for so high open defection in rural India. The social beliefs and culture play a major role in it, the perception of ritual purity, pollution and physical purity has a major role. The people in villages, especially the upper castes find it impure to have a toilet build in their home, because the toilets are that build in villages are usually pit toilets, where the faeces store in the pit and that is something dirty as compared to going out and doing it open. Also, the general perception among the people is that the pits fill in few months and then the question comes, who will clean it? Because in India it has been and sadly it still is a job of a manual scavenger, who is from the Dalit community. And the mindset of people is such that it is a job of the people from a specific cast, and we can’t do it. This stops people from building toilet at home and even if it is built, stops them from using it. At the bottom of it the caste system which makes people defecate in open and stops them using toilets even if they have.

We cannot empty [the latrine pit] ourselves. We call a Bhangi even if something gets clogged in the latrine…..How can we empty it ourselves? It is disgusting, so a Bhangi must come to clean it……We are Hindus, so can we clean it [if we do], how will we worship afterwards? If money were an issue we would take a loan for it, we would have to find some way to get it emptied. This work can only be done by people who inherit this occupation. They are Bhangis, they have been created [by God] for this work.

           – A woman from Sitapur who belonged to a lower, but not a Dalit, caste.

The authors also talk about the health hazards of open defection, especially in densely populated places, which is most of India. The impact of it on the infants, short term, and long term both. Based on various sample data and research, they concluded that not only open defecation is a major health hazard, but it also impacts the economy adversely. Apart from the general notion that open defecation is bad, you will get to know in detail how it impacts us as individual, as a family, community and as a Nation.

Lastly, their research tells us that the government approach of resolving the open defecation is limited to just building toilets and showing the improvement based on how many new toilets has been built. This is the approach since the last three decades when Central Rural Sanitation Programme (CRSP) began in 1986, the Total Sanitation Campaign (TSC), launched in 1999, the Nirmal Bharat Abhiyan, launched in 2012 and now the Swachh Bharat Abhiyan/Mission (SBM), launched in 2014. The sole matrix the track is how many toilets are built and not how many people defecate in open and how many use the toilets. In the whole process the core issue remains out of focus, which is stopping/reducing open defecation and all the focus is shifted to how many toilets are built, and based on that the success is measured, whereas on ground the reality is different.

In speeches and in the newspapers, the prime minister promised that the government would build a toilet for every household. Because over 12.3 crore households reported lacking a toilet or latrine in the 2011 census, this amounted to build about 67,000 new latrines per day over a period of five-year period. Reporters quickly noticed that there are 86,400 seconds in a day.

The authors recommend some steps that can be taken to reduce/stop the open defecation in the villages. The approach needs to change for that, the focus should be on understanding why people defecate in open despite being toilets in their home. Information campaign needs to communicate the goal of Swachh Bharat Mission clearly. Most of the people relate to the campaign and know about it as the PM himself is a part of the major advertisement campaigns. Most of the people associate it with general cleanliness, like keep your vicinity filth free, put the garbage in dustbins, segregate the garbage as biodegradable and others, but mostly don’t associate it with toilet use. A focus should be on understanding the social beliefs of people and run an information campaign to change the social behaviour of people. It is a long-term process, but then merely constructing the toilets is also not solving the purpose. There is big elephant in the room which is a bane of many problems in India, including open defecation and it is “caste system”. It needs to be understood by the policy makers and the governments to resolve the issue of open defecation.

A well-researched and well written book on a subject which many would not consider worth researching and writing. Gives you a new insight about the menace that India is facing and breaks so many myths that people in the urban area have about the open defecation and the reasons behind it. A must-read book for anyone who needs to understand about one of the biggest problems that India is facing right now.

The Authors

Diane Coffey and Dean Spears are visiting researchers at the Economics and Planning Unit of the Indian Statistical Institute in Delhi, assistant professors at the University of Texas at Austin and executive directors of r.i.c.e., a research institute for compassionate economics, online at

Dean Spears is a visiting researcher at the Economics and Planning Unit of the Indian Statistical Institute in Delhi, an assistant professor at the University of Texas at Austin, and an executive director of r.i.c.e., a research institute for compassionate economics. With Diane Coffey, he wrote the award-winning book Where India Goes: Abandoned Toilets, Stunted Development, and the Costs of Caste.

Leave a Comment

Your email address will not be published. Required fields are marked *